The Gulf War and mortality in Israel

Paediatric casualties during OP TELIC

AIM

To audit all paediatric attendances to a British Army Field Hospital during warfighting.

POPULATION

All patients <16-years-old who presented to 34 Field Hospital Accident & Emergency (A&E) Department during warfighting phase of OPTELIC (27 Mar 03 to 01 May 03).

METHOD

A retrospective analysis of A&E attendance register, A&E clinical records, and A&E trainees' logbooks from the department of 34 Field Hospital.

RESULTS

Seventy eight children were treated, mean age 7.9 years. 65.4% were male and 34.6% female. Children accounted for 2.9% of all patients (total attendances 2720) and 32.9% of non-coalition patients (non-coalition attendances 237). 44 (56%) children had burns as the principal injury; 7 (9%) had shrapnel injuries, 5 (6%) had blunt trauma from a road traffic accident. Only one child had GSW. 17% of attendances were related to 'medical' complaints rather than trauma. 78% of children required transfer to a specialist facility.

CONCLUSIONS

Recognition of the potential for paediatric casualties is required to facilitate appropriate planning, training and equipping of medical units deployed on future operations.

Wartime civilian injuries: epidemiology and intervention strategies

BACKGROUND

Trauma is the most important public health risk in wartime. Most preventive effort have addressed the political etiology of armed conflicts and the secondary effects of war (food, water, shelter, sanitation, and vector control). Little to no efforts have addressed the direct prevention and control of war trauma.

METHODS

An extensive review of the literature, with compilation of the most important data.

RESULTS

Civilians are the major wartime targets in recent wars, and account for most of the killed and wounded. The trend has been toward a greater proportion of injuries from powerful explosive devices such as artillery shells and mines. Lessons learned from Bosnia and Lebanon show that the most effective way to achieve successful surveillance and injury prevention is to enhance the local skills and resources.

CONCLUSIONS

New approaches are needed to minimize trauma to civilians. Both political advocacy and local efforts (including modifying firearms and ammunition, bullet proof helmets for children, anti-sniper shields) are needed.